Response to Mencap’s campaign about services for people with learning disabilities and the abuse that took place at Winterbourne View

9 January, 2013

Department of Health’s response to Mencap’s campaign about services for people with learning disabilities and the abuse that took place at Winterbourne View

The abuse revealed at Winterbourne View hospital was criminal. Staff whose job was to care for and help people instead mistreated and abused them. Management allowed a culture of abuse to flourish, warning signs were not picked up or acted on by the authorities, and a whistleblower’s concerns were not listened to.

The abuse uncovered at Winterbourne View prompted a wider review of how one of society’s most vulnerable groups of people is cared for. Subsequent investigations revealed that far too many people with learning disabilities or autism, and who also have mental health conditions or behaviours described as challenging, are staying far too long in hospital settings, as was the case at Winterbourne View.

Whilst people with learning disabilities or autism may sometimes need hospital care, many are staying there for too long – sometimes even for years. Hospitals are not where people should live. Children, young people and adults with learning disabilities or autism can be, and have a right to be, given the support and care they need in their own communities, close to family and friends.

Norman Lamb, Care Services Minister, published the Department’s final report on Winterbourne View on 10 December 2012. It sets out how the Government will work together with national and local health and care organisations to address poor care and abuse and to ensure that excellent care becomes the norm.

The report sets out steps to respond to the failings that Winterbourne View brought to light, and to improve care more generally. While individual members of staff at Winterbourne View have been convicted, ministers believe that this case has revealed weaknesses in our ability to hold the owners, boards of directors and senior managers of care organisations to account. The Government believes that this is a gap in the care regulatory framework that it has committed to address. By the spring, it will set out proposals to strengthen the accountability of boards of directors and senior managers for the safety and quality of care that their organisations provide.

The report highlights how the Care Quality Commission will strengthen inspections and regulation of hospitals and care homes for this group of people, including unannounced inspections involving people who use services and their families.

The report also sets out a programme of action to transform services, so that people no longer live inappropriately in hospital settings but are cared for in line with best practice, based on their individual needs. The programme will also ensure that their wishes, and those of their families, are listened to and are at the heart of planning and delivering their care.

A detailed timetable of action is included in the report. It includes the following measures:

by June 2013, all current hospital placements will be reviewed. Everyone in hospital inappropriately will move to community-based support as quickly as possible, and no later than June 2014; and

by April 2014, each area will have a joint plan to ensure high quality care and support services for all people with learning disabilities or autism and mental health conditions or behaviour described as challenging, in line with best practice.

As a consequence, ministers expect a dramatic reduction in hospital placements for this group of people.

The Government’s commitment to this programme of action is shared by the organisations responsible for delivering change. A concordat, signed by more than 50 organisations, sets out the specific actions that each organisation will take. This was published alongside the final report.

The NHS Commissioning Board and the Local Government Association will lead a joint improvement programme, with financial support from the Department of Health, to supervise these changes. Mr Lamb will chair a Board to oversee progress.

The report focuses on the need for change, but there are places that already get this right. The Department has published examples of best practice alongside the report. These show what is possible, and what must be achieved for everyone.